Question 1

Which of the following are indications for RSV prophylactic therapy? 1) Infants less than 32 weeks and requiring FiO₂ greater than 0.21 for at least the first 28 days of life 2) Cyanotic heart defects in the first year of life 3) Severely immunocompromised children less than 24 months of age 4) Children with cystic fibrosis

Accepted Answer

The answer of Which of the following are indications for...

Question 2

What therapy has been shown to reduce the rate of loss of lung function in patients with cystic fibrosis?

Accepted Answer

High doses of the anti-inflammatory drug ibuprofen reduce the rate of lung function loss in patients younger than 13 years.

Question 3

A 2-year-old boy is in severe respiratory distress. The child is drooling and has labored breathing. Stridor is heard. RR is 42 breaths/min and HR is 148 beats/min. What should be done next?

Accepted Answer

The clinical picture, particularly the age, level of distress, stridor, and drooling, suggests that this patient apparently has epiglottitis, a severe swelling of the tissue around the glottis. Given the potential for additional swelling and complete airway closure, this patient should be intubated for airway protection.

Question 4

What therapy has been shown to reduce the incidence of bronchiectatic exacerbations in the patient with cystic fibrosis?

Accepted Answer

When inhaled tobramycin is used twice daily every other month, there is a marked reduction in the number of bronchiectatic exacerbations.

Question 5

Which of the following therapies is least likely to be needed in the child with epiglottitis?

Accepted Answer

Tracheostomy may be needed if the patient's condition warrants it; however, this procedure is rarely used.

Question 6

Which of the following is the most common radiographic finding that suggests the presence of epiglottitis?

Accepted Answer

The "Thumb sign" is the most common radiographic finding suggesting the presence of epiglottitis, characterized by swelling of the epiglottis seen on a lateral neck X-ray, resembling the shape of a thumb.

Question 7

Which of the following clinical findings is not typically seen in patients with epiglottitis?

Accepted Answer

The patient does not have a croupy bark but instead has a muffled voice.

Question 8

What is the likely diagnosis of an 18-month-old patient in moderate respiratory distress with a 1-week history of a low-grade fever and chills, barking cough, and an AP chest radiograph which shows a steeple sign?

Accepted Answer

A child typically has slow, progressive inspiratory and expiratory stridor and a barking coup. As the disease progresses, dyspnea, cyanosis, exhaustion, and agitation occur.

Question 9

Which test is commonly used to confirm the diagnosis of cystic fibrosis?

Accepted Answer

In evaluation of a child, a sweat chloride level greater than 60 mEq/L confirms the diagnosis of cystic fibrosis.

Question 10

What is the leading cause of death among patients with cystic fibrosis?

Accepted Answer

Complications of lung disease are the leading cause of death among patients with cystic fibrosis.

Quiz 34: Neonatal and Pediatric Respiratory Disorders